Shroud of ignorance around TB

Clinical lead Doctor Al Story points to an x-ray showing a pair of lungs infected with TB (tuberculosis) during an interview with Reuters on board the mobile X-ray unit screening for TB in Ladbroke Grove in London January 27, 2014. The only mobile unit testing for TB in the country works with the most vulnerable to the disease including the homeless, drug and alcohol dependent. REUTERS/Luke MacGregor (BRITAIN - Tags: HEALTH SOCIETY)

Clinical lead Doctor Al Story points to an x-ray showing a pair of lungs infected with TB (tuberculosis) during an interview with Reuters on board the mobile X-ray unit screening for TB in Ladbroke Grove in London January 27, 2014. The only mobile unit testing for TB in the country works with the most vulnerable to the disease including the homeless, drug and alcohol dependent. REUTERS/Luke MacGregor (BRITAIN - Tags: HEALTH SOCIETY)

Published Jul 12, 2014

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Johannesburg - Has your child been screened for tuberculosis at school, crèche or a local clinic?

What does a child’s caregiver know about TB and how it is transmitted? Actually how much do you know about the disease?

These are questions posed by a non-profit organisation as the prevalence of paediatric tuberculosis comes under the spotlight. South Africa is thought to have the highest TB incidence in the world with the disease being the number one cause of deaths in the country.

Up to 60 000 people in South Africa reportedly die from TB every year.

This week a study published in the UK Lancet Global Health indicated that the incidence of childhood tuberculosis could be higher than previous statistics estimated by the World Health Organisation (WHO).

To establish the escalating prevalence of paediatric TB, researchers in the study took a complementary approach, using mathematical modelling to estimate rates of infection and disease in children based on country-specific data, on household and population structure.

They also considered the frequency of TB in adults.

The model incorporated both social and epidemiological variables including the effects of age, the Bacillus Calmette-Guérin (BCG) vaccination effectiveness and the effect of HIV infection.

The South African Medical Journal published a research by the University of Cape Town almost three years ago in which it was stated that the HIV epidemic has had a large impact on the incidence, diagnosis and management of childhood TB.

But while TB is often said to be a disease that affects the poor and those with little access to health-care services, South African National Tuberculosis Association Gauteng co-ordinator Seun Maphoroma said TB had no favourites – so the wealthier middle class was also susceptible.

According to Maphoroma, a vast majority of parents in urban areas were neglecting their children’s health.

He said they could no longer afford cater for their children’s nutritional needs.

He said, for instance, there were scenarios where parents hired people to look after their children during the day, but did not follow up on whether they had knowledge on various health issues or what to do in emergencies.

Lead author Dr Peter Dodd from the University of Sheffield in UK agrees.

He said children were an often ignored but important part of TB control efforts.

Meanwhile, Maphoroma said some women also abandoned breastfeeding and did not realise that excellent nutrition plays a role in combating TB. “When we talk about malnutrition we don’t talk about having insufficient food but rather not eating the right food. Drugs are not the only thing that will heal a person. A holistic approach is needed in this,” he said.

Dodd said a wider use of isoniasid therapy as a preventative measure would probably substantially reduce the numbers of children who would go on to develop the disease.

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